The Relationship Between Self-Esteem, Stigma, and Coping Strategies Among Breast Cancer Patients in Erbil City, 2024–2025.

Yousif Abdulsatar Jabbar; Banaz Othman Ali; Amez Abubakr Omar; Arena Nawzad Awsu; Ahmed Ali Rasool; Mosleh Saber Kareem; Arpi Manookian; Ahmed Naif Ali; Safin Hussein; Abdulmalik Fareeq Saber

doi:10.64048/xmvz9p74

Authors

Yousif Abdulsatar Jabbar College of Nursing, Hawler Medical University, Erbil, Iraq Author https://orcid.org/0009-0000-8907-9840
Banaz Othman Ali College of Nursing, Hawler Medical University, Erbil, Iraq Author https://orcid.org/0009-0000-5476-8072
Amez Abubakr Omar College of Nursing, Hawler Medical University, Erbil, Iraq Author https://orcid.org/0009-0006-6058-9250
Arena Nawzad Awsu College of Nursing, Hawler Medical University, Erbil, Iraq Author https://orcid.org/0009-0006-0024-375X
Ahmed Ali Rasool Psychiatric and Mental Health Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq Author https://orcid.org/0000-0002-4993-6673
Mosleh Saber Kareem Psychiatric and Mental Health Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq Author https://orcid.org/0000-0002-4463-4975
Arpi Manookian Department of Medical Surgical Nursing, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran Author https://orcid.org/0000-0003-0607-0731
Ahmed Naif Ali Psychiatric and Mental Health Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq Author https://orcid.org/0000-0002-0893-4559
Safin Hussein Biology Department, College of Science, University of Raparin, Ranya, Sulaimaniya, Iraq Author https://orcid.org/0000-0001-8513-2907
Abdulmalik Fareeq Saber Psychiatric and Mental Health Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq Author https://orcid.org/0009-0004-0300-0185

DOI:

https://doi.org/10.64048/xmvz9p74

Keywords:

Breast Cancer, Self-Esteem, Stigma, Coping Strategies, Psychological Well-Being, Cancer Patients

Abstract

Background and Aim: Breast cancer patients often face psychological challenges, including diminished self-esteem and stigma, which can impact their coping strategies. This study aimed to assess the levels of self-esteem and stigma among breast cancer patients in Erbil City and analyze their relationship with coping mechanisms.

Method: This cross-sectional study was conducted from June 10, 2024, to February 20, 2025, in two hospitals in Erbil City, using purposive sampling. The study contained four parts, including demographic data and three standardized tools: the Rosenberg Self-Esteem Scale (RSE) to assess self-esteem, the Cancer Stigma Scale (CASS) to evaluate stigma, and the Cancer Coping Questionnaire to measure coping strategies. Data were analyzed using SPSS version 28 (IBM Corp., Armonk, NY), with Pearson correlation and multiple linear regression applied to examine associations between self-esteem, stigma, coping strategies, and demographic variables. Significance was set at p < 0.05.

Results: A total of 109 breast cancer patients participated in the study. The mean scores for self-esteem, stigma, and coping strategies were 26.84 ± 7.33, 122.47 ± 16.90, and 53.47 ± 14.72, respectively, indicating that all three variables were at a moderate level among participants. Pearson correlation analysis revealed a significant negative relationship between stigma and self-esteem (r = -0.16, p < 0.001), suggesting that higher stigma was associated with lower self-esteem. Additionally, stigma was negatively correlated with coping strategies (r = -0.61, p < 0.001), while self-esteem was positively correlated with coping strategies (r = 0.14, p < 0.001), indicating that higher self-esteem was linked to better coping strategies.

Conclusion: The study found that breast cancer patients had moderate levels of stigma, self-esteem, and coping strategies. It is recommended that policymakers and healthcare providers develop targeted psychosocial interventions to reduce stigma, enhance coping mechanisms, and improve self-esteem among breast cancer patients.

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